Elderly suicide is a major public health issue in South Korea. The aim of this study was to systematically examine the current knowledge about suicidal ideation among Korean older adults with specific focus on risk and preventive factors. In order to achieve this aim, a meta-analysis was conducted using Korean academic peer-reviewed journals published since 2001. A total of 97 articles were selected that met the research criteria (e.g., original study findings and key words of suicidal ideation, suicidal thought, and suicide). Three domains were identified and used for further analysis: individual, family, and society. Results showed that among individual factors, depression and burden or stress increased the risk of suicidal ideation, while better mental health reduced the risk of suicidal ideation. Among family factors, living alone was a risk factor for suicidal ideation, while family cohesion was a preventive factor for suicidal ideation. Among social factors, elderly discrimination, social isolation, and negative relationships were significant risk factors, while social support, social environment, and social activities were significant preventive factors affecting suicidal ideation. The results suggest several practical implications for developing suicide prevention programs and counseling approaches to address suicidal ideation. For example, depression and stress can be reduced by MBSR (Mindfulness-Based Stress Reduction) program where meditation is used as a coping strategy. In addition, counseling programs specifically focused on improving family and social relations should be implemented. Government should continuously support for these programs to prevent suicide among older Koreans.